Page 45 - Delaware Medical Journal - March/April 2021

PRACTICE MANAGEMENT
CASE REPORT
started doing it pretty rapidly right after coronavirus started. At the peak, we were doing 90% telemedicine.”
Still, Varipapa’s practice also encountered some hurdles on the patient side, including a lack of good internet service, and an older patient population that still used phones without video capability.
But a year later, physicians have learned key lessons about how to make telemedicine work for their practice and their patients. Here are some of the most important ones:
• Find a solution that meets your patients where they are. Many of Saldarriaga’s patients lacked the tech knowledge
or access required to navigate a telemedicine platform, she says. So she ultimately decided against adopting an expensive new software that patients would be unable to use. Instead, Saldarriaga has conducted her telemedicine appointments using her patients’ smartphone cameras. When there is an issue with the quality of the video, Saldarriaga will ask patients to send her photos of anything they particularly want her to look at, such as a skin lesion.
• Check in with patients the day before a telemedicine visit. Kathlyn L. Rowen, MD, an independent practice psychiatrist in Wilmington, has hired a staffer who will call every patient on of the appointment and the platform the patient prefers to use, such as FaceTime or Zoom. That way, Rowen says, the patient is ready for the appointment and sure to be on a platform that they’re comfortable with.
• Do what you can to create connection. It’s harder to see the whole patient on a video call, but there are some things Rowen has been doing to improve the experience for both sides. “I make sure my camera’s set up so I’m at eye level with the patient — not looking up or down,” she says. “And I make sure there’s only indirect lighting so the patient can see me.” Rowen also does her best to meet with patients in a distraction-free environment — such as a room where she won’t be able to hear her dogs barking if she’s working from home.
• Consider how your visit schedule might need to change for telemedicine. Rowen discovered that it was harder to take extensive notes during a video call, because she needed to pay close attention to the screen to get the visual cues on a patient’s well-being she would pick up more easily during an in-person visit. This means extra time writing notes after the visit, which Rowen has had to take into account for scheduling.
• Use a second screen for interactions with the patient. Varipapa’s practice decided to add iPads to a lot of its exam rooms because it was challenging to review the patient’s electronic medical record on the same screen where the video call was being conducted. Having a separate screen available makes it easier to refer back to the record without interrupting face time with the patient.
Despite some of the challenges of the initial adoption, the physicians agree that even once the pandemic subsides, telemedicine isn’t going anywhere. “I think we’re going to have a blended system,” says Rowen. “Telemedicine is a great modality that offers physicians a chance to keep in contact with their patients when they’re sick or don’t want to drive or have moved out of the area. It’s another way to give the treatment that someone needs.”
“I think it’s become a nice vehicle for a certain class of patients,” Varipapa agrees. “For patients with relatively simple problems, a
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Del Med J | March/April 2021 | Vol. 93 | No. 2
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